Abstract
BackgroundCancer-related fatigue (CRF) is a common symptom affecting patients with cancer. There are an increasing number of trials examining potential treatments for CRF. Methylphenidate represents one of the most researched drugs and an up-to-date assessment of the evidence for its use is needed. Trials of methylphenidate for CRF provided inconsistent results. This meta-analysis was aimed at assessing the effect and safety of methylphenidate on CRF.MethodsWe comprehensively searched the Pubmed, EMBASE, PSYCHInfo and the Cochrane databases in order to identify published studies on the effect of methylphenidate on CRF. Primary outcomes included fatigue. Secondary outcomes included depression, cognition and adverse effects.FindingsA meta-analysis was conducted on five randomized controlled trials and 498 patients were enrolled. Despite a large placebo effect observed in the studies included, pooled data suggested therapeutic effect of methylphenidate on CRF. Subgroup Analyses showed that the efficacy of methylphenidate on CRF is getting better with prolonging treatment duration, with a MD of −3.70 (95% CI −7.03– −0.37, p = 0.03) for long-time group and a MD of −2.49 (95% CI −6.01–1.03, p = 0.17) for short-time group. In general, there was no impact of methylphenidate on depression and cognition associated with CRF. Adverse events were similar between methylphenidate and placebo groups except that more patients reported vertigo, anxiety, anorexia and nausea in methylphenidate group compared to placebo group.ConclusionExisting trials of methylphenidate on CRF provided limited evidence for the use of methylphenidate to treat CRF. The absolute numbers still remain small, and further confirmation is needed before firm recommendations on their usage and safety can be made in the treatment of CRF.
Highlights
Cancer-related fatigue (CRF) is a significant clinical problem affecting patients at all stages of treatment and increases with advanced diseases [1]
Despite a large placebo effect observed in the studies included, pooled data suggested therapeutic effect of methylphenidate on CRF and the efficacy of methylphenidate on CRF is getting better with prolonging treatment duration
The analysis of serious adverse effects failed to demonstrate any significant differences between groups, except that more patients reported vertigo, anxiety, anorexia and nausea in methylphenidate group compared to placebo group
Summary
Cancer-related fatigue (CRF) is a significant clinical problem affecting patients at all stages of treatment and increases with advanced diseases [1]. Pharmacological interventions consisting of prescription of low-dose steroids, modafinil, and psychostimulants, such as methylphenidate, dexamphetamine or pemoline may be appropriate [9]. Among these modalities that have been evaluated to date, methylphenidate seems to be the most promising pharmacological agent for CRF. Cancer-related fatigue (CRF) is a common symptom affecting patients with cancer. Trials of methylphenidate for CRF provided inconsistent results. This meta-analysis was aimed at assessing the effect and safety of methylphenidate on CRF
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call